Acupuncture and Oriental Medicine Clinic

Frequently Asked Questions About Chinese Herbs

Are Chinese herbs safe?

Chinese herbal products manufactured and imported by American companies are strictly regulated by the FDA (Food and Drug Administration). It should be noted that pre-made patent (pill form) herbs produced in the People's Republic of China by Chinese companies are not held to the same high standards. American (and some European and Australian) herb companies ensure the safety and quality of Chinese herbs by rigorously testing for contaminants, toxins, and heavy metals, and by employing meticulous methods of correct species identification. For more details on these regulations and testing methods, see The Issue of Safety and Quality of Chinese Herbs.

Are all herbs derived from plant material?

The great majority of Chinese herbs are of plant origin, such as roots, barks, twigs, seeds and rhizomes. Occasionally minerals, shells, or animal products are used in herbal formulations. For those wishing to avoid the use of medicinal herbs from animal sources, these products can be omitted from their individualized herb formulas.

How are Chinese herbs administered?

Chinese herbs are generally prescribed in formulations containing 4 to 12 or more herbs, as the synergistic use of several substances creates a dynamic effect that cannot generally be achieved by a single plant. Traditionally, the raw, dried herbs are cooked as a decoction by simmering in water for a period of time, then strained and drunk as a tea. Herbal formulas are now also available in concentrated granules that easily dissolve in water, as well as in the form of tinctures, capsules or tablets. Herbs for topical use may be prescribed and are used in the form of lineaments, washes, salves, and plasters.

What are Chinese herb granules?

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Chinese herb granules are manufactured in a carefully controlled process that begins by cooking raw herbs in water until a concentrated liquid is obtained. A special extraction method captures and preserves the volatile oils, which are later added back to the herb product. The herb liquid is highly concentrated, slowly dried, and sprayed onto a base of finely powdered herb material or potato starch. After drying, this is ground into powder, resulting in herb granules that are easily dissolvable in liquid.

These granules are concentrated to a potency of about 5:1, which means that 5 kg of dried herb material is used to produce 1 kg of concentrate. With the resulting product, consuming about 10 grams of granules daily equals the potency of taking 50 grams of raw herb in decoction. The granules are prepared under the strict laboratory conditions and GMP (Good Manufacturing Practice) regulations, each batch being tested to assure optimal potency and safety.

State of the art testing is performed on the herb granules and only those passing high standards for safety and efficacy are used. Laboratory tests check for potential microbes such as E. coli, salmonella and other contaminants. Gas Chromatography (GC) testing is used to detect potentially harmful pesticides and herbicides, Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) assesses the concentration of heavy metals, and High Pressure Liquid Chromatography (HPLC) measures the potency of active ingredients.

What are the advantages and disadvantages of taking herbs in decoction, granule, or pill form?

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In general, herbs taken in decoction form have the strongest effect. In this method, the dried herb material is cooked for a period of time, usually about one hour, then strained and drunk as a tea. The disadvantage with this form of administration is the time it takes to cook and prepare the tea, and the relatively strong smell and taste.

Herbs in concentrated granules are slightly less potent than decoctions when taken at the standard recommended dosage. However their convenience often outweighs this disadvantage. There is no need for cooking as they easily dissolve in fluid, and are therefore time saving and relatively easy to take at home or away. Granules, like decoctions, can be prescribed in individualized formulas that are custom tailored for each person's specific constitution and health concerns.

Both decoctions and concentrated granules are more potent than herbs in pill form, when taken at the usual recommended dosage. Pills are suitable for conditions where slow, steady herbal support is appropriate, or in acute situations where a high dose may be needed for a short period of time. This form is ideal to take when traveling and for those who are very sensitive to the taste of herbs, or for other reasons find it difficult to take liquid preparations. Herbs in pill form are pre-made, standardized formulations, therefore can be difficult to customize. In order to achieve the targeted response, taking a combination of two or three different formulas in pill form is sometimes necessary.

Are there any side effects from taking herbs?

Traditional Chinese herbal medicine uses herbs only in their whole form, meaning that certain chemical constituents of the plants are not extracted and removed, or unnaturally concentrated. As such, herbs have very few side effects, and when prescribed by a well-trained herbalist, problems are minimal to none. The main potential concern with these herbs is the ability to easily digest the potent plant constituents. Chinese herbalists will carefully consider this factor and include herbs that promote digestion as needed.

Can I take herbs if I am taking prescription medications?

When seeing a Chinese herbalist, you should bring a list of any medications you are taking to your appointment. Herbs may not be appropriate if you are taking some beta-blockers, hypertensive or blood thinning medications or if you have kidney and/or liver metabolism issues. A well-trained herbalist will know which herbs should be avoided with certain medications and supplements.

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Can I take Chinese herbs if I am pregnant?

The actions and effects of Chinese herbs have been meticulously observed and classified for over a thousand years. There are many herbs that are considered contraindicated for use during pregnancy. Though many of these herbs are prescribed in small dosages when treating pregnant patients by doctors in China, herbal practitioners in the West tend to be much more conservative. These herbs are well documented, and Chinese herbalists are trained to strictly avoid their use with pregnant patients. There are hundreds of other Chinese herbs that are absolutely safe for use in pregnancy, and in fact, are often very helpful in calming potential threatened miscarriage symptoms and for other obstetric problems.

Are herbs safe to take if I am breastfeeding?

As with foods, medications, and supplements, when taken by breastfeeding moms, small amounts of herbal medicine will enter the breast milk and be passed on to the baby. For this reason, herbalists are careful when treating breastfeeding mothers, but it is not necessary to avoid taking herbs all together. Herbs that gently nourish the body, encourage optimal digestion, support immune function, and otherwise promote relaxation and vitality, may be taken safely.

Can children take herbal medicine?

Many Chinese herbs are safe and effective for treating pediatric conditions when dosages are adjusted appropriately for the child's body weight. Often they will be administered in liquid tincture form, or granules that can be dissolved into juice or pureed fruit. Herbs should be given to children only when prescribed by an experienced, well-qualified herbalist trained in pediatric care.

How do I choose a qualified herbalist?

Chinese herbalists in the U.S. must have a board certified license to practice Oriental medicine. However some practitioners have chosen to pursue extensive education in herbal medicine beyond the required acupuncture training. A well-trained herbalist will have completed a Master's level acupuncture program, at least two years of study in Chinese herbal medicine, and will have significant clinical practice experience.